Perinatal Dangers

    Since a woman sometimes does not know if she is pregnant right away, once you are trying to conceive it is important to make certain life style choices concerning personal habits such as smoking and drugs.  It is also important to be mindful of everyday things such as having a bath or enjoying a hot tub at the local recreation center.  These things may seem to play a somewhat trivial role in your pregnancy,  but,  in fact,  they affect the health of the expecting mother and the baby immensely. 

Smoking:

    Smoking during pregnancy harms both the mother and the fetus.  In the mother it increases the risk of (2,4): 

•    cardiovascular and pulmonary diseases
•    cancer in the mother
•    problems with the placenta
•    bleeding early or late in pregnancy, premature or prolonged rupture of membranes

   In the fetus smoking during pregnancy is linked to several negative health outcomes of the fetus (2,4):

•     low birth weight 
•     small for gestational age
•     premature birth
•     congenital defects
•     spontaneous abortion
•     ectopic pregnancy
•     perinatal mortality

There also is research evidence to suggest that the children of whose parents smoke have a greater chance of developing cancer, these children tend to have more chest infections and hospitalizations during their first year of life. (2)

Alcohol:

The key point about drinking alcohol when pregnant is that when you drink, so does your baby.  Alcohol consumed by a pregnant women rapidly crosses the placenta, producing equivalent concentrations in fetal circulation (2).  Alcohol can affect the baby's fast growing tissues, either by killing cells or by slowing their growth.  The baby's brain is most severely affected by alcohol (4).   

 In severe cases, children born of women who drink during pregnancy are said to have Fetal Alcohol Syndrome (FAS): 

• they are smaller than normal 
• tend to have joint, facial, and limb abnormalities  
• may have heart defects, poor co-ordination, and mental retardation

Other potential problems include hyperactivity, extreme nervousness, and poor attention span (4).

There is no safe level of alcohol consumption during pregnancy, it is advised that a woman should stop drinking alcohol entirely when pregnant. 

Drugs:

There is evidence to show that some drugs are not harmful to the unborn child, dome that are neither safe nor unsafe, and still others have been found to be extremely harmful, resulting in problems early in the child's life and some problems that last right through their adult life.  For more in depth information about any drugs a physician should be consulted.  There are some drugs however that deserve some special attention:

Marijuana

Marijauna contains tar and nicotine and when smoked produces carbon monoxide, which has the same effects of smoking, if not greater (4).  There is also evidence of other harm to the mother and fetus, so marijuana should be avoided during pregnancy.  

Narcotics 

Narcotics produce much more severe harmful effects on the baby.  Narcotics include heroin, methadone, and other mood-altering drugs.  A baby who has been exposed to these drugs during pregnancy due to use by their mother will require special treatment to reduce the effects that may appear immediately after birth or much later in the future (4).       

Cocaine

Cocaine increases the risk of placenta separating from the uterus, lower birth weight, and preterm labour (4).

NOTE:  A pregnant woman using any drug or drugs should consult her physician and discuss the possible choices for withdrawal from use.  

Saunas, Hot Tubs and Baths

If a pregnant woman wants to use a sauna, hot tub or bath, they must use extreme caution so as not to cause hyperthermia.  

• do not stay in longer than ten minutes
• the temperature of the water should be below 38.9^oC or 102^oF
• have another adult around to assist you in getting in and out 
• if you feel dizzy, faint or have a rapid pulse, irregular heartbeat, stomach pain, or tingling in the feet or hands - get out immediately
• prolonged use of hot tubs and whirlpools may lead to episodes of hypotension, which could be detrimental to the fetus. (1) 

Points of Interest

• Overall, 28% of Canadian women smoke.  The proportion of smokers is highest amongst women aged 20 to 24 years with one third (34%) smoking.  Among current women smokers, 58% smoked during their most recent pregnancy (2).

• 13% to 21% of women smokers quit smoking when planning to become pregnant or upon finding out they are pregnant. Another 2% to 22% may quit later in pregnancy (3).

• In Ottawa-Carelton, prevalence rates for smoking during pregnancy decreased from 28.5% in 1983 to 18.7% in 1992.  There was also a significant increase in the number of women quitting in early pregnancy from about 24% to 29% (3). 

• In the 1990 Ontario Health Status Survey, 14% of pregnant women reported that they smoked daily and almost 2% said they smoked occasionally.  In comparison, about 28% of non-pregnant women of childbearing age smoked daily and about 7% smoked occasionally (3).

References

1.  Artal, R. & Sherman, C. (1999). Exercise During Pregnancy. The Physician and Sportsmedecine, 27 (8).

2.  Health Canada. (1999). Nutrition for a Healthy Pregnancy: National Guidelines for the Childbearing Years. Ottawa: Minister of Public Works and Government Services Canada.     

3.  Health Canada. (1995). Smoking and Pregnancy: A Woman's Dilemma. Ottawa: Government Printing Branch.   

4.  Ministry of Health, Province of British Columbia.  (1992).   Baby's Best Chance (3rd ed.)  Toronto: Macmillan. 

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